@article {Patel, author = {S.H. Patel and M.E. Cunnane and A.F. Juliano and M.G. Vangel and M.A. Kazlas and G. Moonis}, title = {Imaging Appearance of the Lateral Rectus{\textendash}Superior Rectus Band in 100 Consecutive Patients without Strabismus}, year = {2014}, doi = {10.3174/ajnr.A3943}, publisher = {American Journal of Neuroradiology}, abstract = {BACKGROUND AND PURPOSE: The lateral rectus{\textendash}superior rectus band is an orbital connective tissue structure that has been implicated in a form of strabismus termed sagging eye syndrome. Our purpose was to define the normal MR imaging and CT appearance of this band in patients without strabismus. MATERIALS AND METHODS: Orbital MR imaging and CT examinations in 100 consecutive patients without strabismus were evaluated. Readers graded the visibility of the lateral rectus{\textendash}superior rectus band on coronal T1WI, coronal STIR, and coronal CT images. Readers determined whether the band demonstrated superotemporal bowing or any discontinuities and whether a distinct lateral levator aponeurosis was seen. Reader agreement was assessed by κ coefficients. Association between imaging metrics and patient age/sex was calculated by using the Fisher exact test. RESULTS: The lateral rectus{\textendash}superior rectus band was visible in 95\% of coronal T1WI, 68\% of coronal STIR sequences, and 70\% of coronal CT scans. Ninety-five percent of these bands were seen as a continuous, arc-like structure extending from the superior rectus/levator palpebrae muscle complex to the lateral rectus muscle; 24\% demonstrated superotemporal bowing; and in 82\% of orbits, a distinct lateral levator aponeurosis was visible. Increasing patient age was negatively associated with lateral rectus{\textendash}superior rectus band visibility (P = .03), positively associated with lateral rectus{\textendash}superior rectus band superotemporal bowing (P = .03), and positively associated with lateral levator aponeurosis visibility (P = .01). CONCLUSIONS: The lateral rectus{\textendash}superior rectus band is visible in most patients without strabismus on coronal T1WI. The age effect with respect to its visibility and superotemporal bowing could represent age-related connective tissue degeneration. Abbreviations LR-SR bandlateral rectus{\textendash}superior rectus band}, issn = {0195-6108}, URL = {https://www.ajnr.org/content/early/2014/04/24/ajnr.A3943}, eprint = {https://www.ajnr.org/content/early/2014/04/24/ajnr.A3943.full.pdf}, journal = {American Journal of Neuroradiology} }